Transcranial Direct Current Stimulation of the Ventromedial Prefrontal Cortex Modulates Perceptual and Neural Patterns of Fear Generalization

Roesmann, Kati; Kroker, Thomas; Hein, Sarah Maria von; Rehbein, Maimu Alissa; Winker, Constantin; Leehr, Elisabeth J.; Klucken, Tim; Junghöfer, Markus

doi:10.1016/j.bpsc.2021.08.001

Cited by 15 publications

(36 citation statements)

References 46 publications

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“…To intensify the UCS and to adhere to previous studies employing mainly auditory or audiovisual UCS (e.g. Onat and Büchel, 2015 , Schiele et al, 2016 , Roesmann et al, 2022a ), pictures were presented together with an aversive scream, taken from the ‘IADS‘ ( Bradley & Lang, 1999 ) or a white noise with matched acoustic characteristics and stimulus duration (1200 ms). Both sounds were presented 60 dB above the patients individual hearing threshold (see SM1.2 ) and were combined with both pictures in a counterbalanced manner.…”

Section: Methodsmentioning

confidence: 99%

Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia – Evidence from magnetoencephalography

Roesmann

Toelle

Leehr

et al. 2022

NeuroImage: Clinical

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Section: Methodsmentioning

confidence: 99%

Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia – Evidence from magnetoencephalography

Roesmann

Toelle

Leehr

et al. 2022

NeuroImage: Clinical

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“…The stimulation was applied during the 20 min of VR exposure (the computerized activation of NIC 2.0 automatically occurred when the VR software ran the exposure). The anode (Pistim ® of π cm 2 ) allowed the use of a highly conductive saline gel (Electrode Gel Signagel ® ) and not a wet sponge in order to avoid the humidification of the VR helmet just below, which was placed (and fixed in the head neoprene cap) over FpZ according to the EEG 10-20 system in order to target the ventromedial prefrontal cortex (vmPFC), and the cathode (Sponstim ® , 25 cm 2 ) was placed under the chin according to one previous current direction modelization for this target using an anodal stimulation of 1.5 mA with a 3 × 3 cm 2 electrode on FpZ and a 5 × 5 cm 2 return electrode, as published by Junghofer et al in 2017 [42]; this method was used in a recent tDCS-MEG study demonstrating that vmPFC hypoactivity is associated with fear generalization [47] (Figure 6). The cathode was maintained thanks to a fixation located at the level of the bandoliers of the Starstim cap, which passed under the chin.…”

Section: Tdcs Device and Protocolmentioning

confidence: 99%

Feasibility of Combining Transcranial Direct Current Stimulation and Active Fully Embodied Virtual Reality for Visual Height Intolerance: A Double-Blind Randomized Controlled Study

Bulteau

Laurin

Bach-Ngohou

et al. 2022

JCM

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Background: Transcranial Direct Current Stimulation (tDCS) and Virtual Reality Exposure Therapy (VRET) are individually increasingly used in psychiatric research. Objective/Hypothesis: Our study aimed to investigate the feasibility of combining tDCS and VRET with the features of wireless, 360° full immersion and embodiment and an active task to reduce height-induced anxiety. Methods: We carried out a pilot randomized, double-blind, controlled study associating VRET (two 20 min sessions with a 48 h interval, during which, participants had to cross a plank at rising heights in a building in construction) with online tDCS (targeting the ventromedial prefrontal cortex) with 28 participants. The primary outcomes were the sense of presence level and the tolerability. The secondary outcomes were the anxiety level (Subjective Unit of Discomfort) and the salivary cortisol concentration. Results: We confirmed the feasibility of the association between tDCS and fully embodied VRET associated with a good sense of presence without noticeable adverse effects. In both groups, a significant reduction in the fear of height was observed after two sessions, with only a small effect size of add-on tDCS (0.1) according to the SUD. The variations of cortisol concentration differed in the tDCS and sham groups. Conclusion: Our study confirmed the feasibility of the association between wireless online tDCS and active, fully embodied VRET. The optimal tDCS paradigm remains to be determined in this context to increase effect size and then adequately power future clinical studies assessing synergies between both techniques.

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“…Changes of cortical excitability can last up to one hour after a single stimulation (Poreisz et al, 2007). We implemented the tDCS-montage as used in our previous studies to non-invasively stimulate the vmPFC (Junghofer et al, 2017;Roesmann et al, 2021;Winker et al, 2020Winker et al, , 2019Winker et al, , 2018. The active electrode was placed on the forehead (3 x 3 cm) and the extracephalic reference under the chin (5 x 5 cm).…”

Section: Tdcsmentioning

confidence: 99%

Noninvasive stimulation of the ventromedial prefrontal cortex modulates rationality of human decision-making

Kroker

Wyczesany

Rehbein

et al. 2022

Preprint

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The framing-effect is a bias that affects decision-making depending on whether the available options are presented with positive or negative connotations. Even when the outcome of two choices is equivalent, people have a strong tendency to avoid the negatively framed option because losses are perceived about twice as salient as gains of the same amount (i.e. loss-aversion). The ventromedial prefrontal cortex (vmPFC) is crucial for rational decision-making, and dysfunctions in this region have been linked to cognitive biases, impulsive behavior and gambling addiction. Using a financial decision-making task in combination with magnetoencephalographic neuroimaging, we show that excitatory compared to inhibitory non-invasive transcranial direct current stimulation (tDCS) of the vmPFC reduces framing-effects while improving the assessment of loss-probabilities, ultimately leading to increased overall gains. Behavioral and neural data consistently suggest that this improvement in rational decision-making is predominately a consequence of reduced loss-aversion. These findings recommend further research towards clinical applications of vmPFC-tDCS in addictive disorders.

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Transcranial Direct Current Stimulation of the Ventromedial Prefrontal Cortex Modulates Perceptual and Neural Patterns of Fear Generalization

Cited by 15 publications

References 46 publications

Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia – Evidence from magnetoencephalography

Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia – Evidence from magnetoencephalography

Feasibility of Combining Transcranial Direct Current Stimulation and Active Fully Embodied Virtual Reality for Visual Height Intolerance: A Double-Blind Randomized Controlled Study

Noninvasive stimulation of the ventromedial prefrontal cortex modulates rationality of human decision-making

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